<%@ taglib uri="http://java.sun.com/jsp/jstl/functions" prefix="fn"%>
<%@ taglib prefix="c" uri="http://java.sun.com/jsp/jstl/core"%>
<%@ taglib uri="http://java.sun.com/jstl/fmt" prefix="fmt" %>
<jsp:include page="/jsp/layout/cabecalho.jsp" flush="true"/>
<jsp:include page="/jsp/layout/menu.jsp" flush="true"/>

<div id="box_principal">
	<div id="box_top">&nbsp;</div>
	<div id="box_titulo">
		<font class="titulo"><b>Forma de Pagamento escolhida: Cart&atilde;o Visa 
		<img src="/SDC/images/visa.png" style="cursor:pointer" id="visa" align="absmiddle" alt="" width="62" height="62" />
		</b>
		</font>
	</div>
	<div id="box_form">
	<table width="530" border="0" align="center" cellpadding="0" cellspacing="0" id="ctrl">	
	</br>
	<tr>
		<td align="right">
		<b>
		<fmt:message key="fatura_cartao.nome"/>
		</b>
		</td>
		<td><input type="text" value="" name="nome_titular"></input></td>
	</tr>
	<tr>
		<td align="right">
		<b>
		<fmt:message key="fatura_cartao.numero"/>
		</b>
		</td>
		<td>
		<input type="text" value="" name="numero_cartao"/>
		</td>
	</tr>	
	<tr>
		<td align="right">
		<b>
		<fmt:message key="fatura_cartao.validade"/>
		</b></td>
		<td><select name="validade_mes">
		<option value="<fmt:message key="campo.selecione"/>" selected="selected">
		<fmt:message key="fatura_cartao.validade.mes"/></option>
		<option value="1">1</option>
		<option value="1">2</option>
		<option value="1">3</option>
		<option value="1">4</option>
		<option value="1">5</option>
		<option value="1">6</option>
		<option value="1">7</option>
		<option value="1">8</option>
		<option value="1">9</option>
		<option value="1">10</option>
		<option value="1">11</option>
		<option value="1">12</option>
		</select></td>
		<td align="left">
		<select name="validade_ano">
		<option value="<fmt:message key="campo.selecione"/>" selected="selected">
		<fmt:message key="fatura_cartao.validade.ano"/></option> 
		<option value="2010">2010</option>
		<option value="2011">2011</option>
		<option value="2012">2012</option>
		<option value="2013">2013</option>
		<option value="2014">2014</option>
		<option value="2015">2015</option>
		<option value="2016">2016</option>
		<option value="2017">2017</option>
		<option value="2018">2018</option>
		<option value="2019">2019</option>
		<option value="2020">2020</option>
		</select></td>
	</tr>	
	<tr>
		<td align="right"><b>
		<fmt:message key="fatura_cartao.codigo"/>
		</b>
		</td>
		<td><input type="text" value="" name="cod_seguranca"/></td>
	</tr>	
	<tr>
		<td align="right"><b>
		<fmt:message key="fatura_cartao.parcelas"/>
		</b>
		</td>
		<td>
		<input type="text" value="" name="numero_parcelas"/></td>
	</tr>								
	</table>
	<form action="/SDC/SacolaServlet?action=encerrar" method="post">
		<input id="bt_prosseguir" src="/SDC/images/bt_prosseguir.gif" type="image"/>
	</form>
		
		
	</div>
	<div id="box_bottom">&nbsp;</div>
</div>	

<jsp:include page="/jsp/layout/rodape.jsp" flush="true"/>